Immigration order could have big impact on N.Y. Medicaid

Hundreds of thousands of undocumented immigrants could become eligible for New York's Medicaid program in 2015 because of the executive order President Obama is expected to announce Thursday night during a prime-time address to the nation.

The order is expected to protect as many as 5 million undocumented immigrants from deportation, but the new legal status will not entitle immigrants to subsidies under the Affordable Care Act or for federal Medicaid dollars.

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That's caused consternation among immigration advocates who argue health benefits are a civil right and an important part of living in the United States.

But in New York, the president's order, which Governor Andrew Cuomo said he supports, could have a significant impact on the uninsured rate, potentially allowing hundreds of thousands of undocumented immigrants to be eligible for state Medicaid dollars.

New York is one of the few states that provides health benefits to non-citizens, or those people who are residing under the color of law (PRUCOL).

In 2001, the state Court of Appeals ruled that denying Medicaid to any legal resident violated the equal protection clauses of the New York and U.S. constitutions. As a result, immigrants in New York who are not citizens but are living in the state lawfully are entitled to Medicaid.

The state, which usually receives a 50-percent match from the federal government for Medicaid expenses, pays the entire share because federal dollars are not allowed for that purpose.

In 2012, when Obama created the Deferred Action for Childhood Arrival (DACA) program, he granted legal status to children brought here illegally by their parents. That applied to 86,000 New Yorkers between the ages of 15 and 30.

That meant tens of thousands of immigrants were newly eligible for Medicaid in the state, though many are unaware of it and have not enrolled.

But what the president is laying out Thursday night could have an even broader impact.

About half of the state's undocumented population is uninsured, according to the UCLA Center for Health Policy Research.

If the president's executive order extends to parents of U.S. citizens and legal permanent residents, then as many as 250,000 to 300,000 immigrants could be eligible for relief in New York state, according to estimates from the New York Immigration Coalition.

If Obama's order were to cover the parents of DACA-eligible immigrants, the number could swell to more than 500,000.

Some of those immigrants already have health insurance and some earn too much to qualify for Medicaid but the effect the order could have on the state's uninsured rate should not be underestimated, said Claudia Calhoon, health advocacy senior specialist at the New York Immigration Coalition.

"There are going to be people who before were not eligible for coverage who now will be eligible for Medicaid and that will be amazing," Calhoon said.

The challenge, Calhoon said, is getting the word out.

"It will be up to us to let them know that one of the benefits ... is they get access to health insurance," Calhoon said.

The People's Budget Coalition for Public Health, a group of labor and community organizations, has asked the City Council for $5 million to advertise the Affordable Care Act and help people enroll.

Obama's executive order would have no effect on the state's health exchange. Even though it is run by the state, the subsidies to purchase health insurance come in the form of premium tax credits. It's a federal program and therefore New York immigrants who earn too much to qualify for Medicaid would be ineligible for subsidies on the exchange.

CORRECTION: This story initially referred to the People's Coalition for Public Health. It is the People's Budget Coalition for Public Health.